The medical record, the collection of notes and other documents concerning a
particular patient, is a time-honored and robust institutional artifact. However,
with patients with chronic ailments that typically are treated and monitored by
multiple clinical workers, sometimes at different institutions, the medical record
is more than ‘beginning to burst’: it is beginning to fragment.
This becomes clear from our ongoing study of the coordinative practices of
clinical workers dealing with patients with ‘implantable cardioverter-defibrillators’
(ICDs), i.e., pacemakers that dub as defibrillators....